tbuckley/cabot-search huggingface dataset:
POS1194 COVID-19 IN PATIENTS WITH INFLAMMATORY MYOPATHY
Authors: A. Hočevar, B. Radič, M. Krosel, M. Tomsic, Z. Rotar
Journal: Annals of the Rheumatic Diseases (2022)

Background Older age, male sex, multimorbidity and glucocorticoids emerged in rheumatic patients as risk factors for severe COVID-19. Objectives We aimed to evaluate the frequency and severity of COVID-19 in a well-defined cohort of patients with idiopathic inflammatory myopathy (IIM). Methods We analyzed medical records of IIM patients diagnosed and followed at our secondary/tertiary center between January 2005 and December 2021. Results During the 204-month period IIM was newly diagnosed in 191 patients, of whom 52 died before COVID-19 pandemic. Of the remaining 139 patients (69.8% females; 9 polymyositis, 47 dermatomyositis; 38 antisynthetase syndrome, 26 overlap syndrome; 17 immune mediated necrotizing myopathy; 2 inclusion body myositis), SARS-CoV-2 infection was proven in 13 (9.4%) patients (61.5% females, mean (SD) age at infection 62.9 (±16.8 years)). Seven/13 COVID-19 patients (53.8%) had a diagnosis of antisynthetase syndrome. At the time of infection IIM was in a remission in 12/13 patients and relapsed 5 weeks earlier in one patient. Seven patients were without immunomodulatory therapy, 1 patient was on steroids alone, 2 on DMARD alone, 3 on steroids and DMARD; a mean daily prednisolone equivalent dose was 5 mg). Eleven/13 (84.6%) patients had mild COVID-19 (one had an asymptomatic infection) and were treated symptomatically, while 2 patients were hospitalized due to severe infection (respiratory insufficiency). Table 1 shows clinical characteristics and duration of COVID-19 symptoms. During pandemic overall 9/139 (6.5%) patients with IIM died, including one patient due to COVID-19. Table 1. Characteristics of COVID-19 in IIM patients Legend: IIM idiopathic inflammatory myopathy; PM polymyositis, DM dermatomyositis; ASyS antisynthetase syndrome, OS overlap syndrome; IMNM immune mediated necrotizing myopathy; F female; M male; DMARD immunomodulatory drug. Conclusion In our IIM cohort, antisynthetase syndrome represented a higher relative risk for COVID-19 compared to other IIIM subtypes. Disclosure of Interests None declared
POS1286 SEVERITY OF COVID-19 IN PATIENTS WITH RHEUMATOID ARTHRITIS RECEIVING BIOLOGICAL DMARDs
Authors: R. Samigullina, A. Dadalova, E. Vasilenko, V. Mazurov
Journal: Annals of the Rheumatic Diseases (2022)

Background The safety of biological DMARDs for rheumatic diseases in the context of the covid 19 pandemic is one of the key aspects of modern rheumatology Objectives assess the severity of the course of COVID-19 infection in patients with rheumatoid arthritis receiving various biological disease-modifying antirheumatic drugs. Methods to assess the severity of the course of SARS-CoV-2, discharged epicrisis from hospitals or the conclusion of computed tomography were used. Since March 2020 to November 2021, among the 1389 patients with rheumatic diseases observed at the of the anticytokine therapy center of the North-Western State Medical University Named after I.I. Mechnikov 105 cases of COVID-19 infection of patients with rheumatoid arthritis were registered, of which 53 patients received outpatient treatment, and 52 patients received inpatient treatment. In 76% of cases, patients received biological DMARDs in combination with synthetic DMARDs. Results In patients treated on an outpatient basis, only 17% (9 patients) underwent chest X-ray examination, according to which grade 2 CT was observed in three patients. Among hospitalized patients, multispiral computed tomography was performed in all cases (n=8; 15.3%) of this group of interstitial lung lesions consistent with CT-1. At the same time, CT-2 was determined in 25 (48,1%), CT-3 - in 16 (30.8%), CT-4 - in 3 (5.8%) (2 lethal cases) patients. The most severe cases of COVID-19 (CT-3 and CT-4) were observed most often in patients (12 and 3, respectively) treated with rituximab (Table 1). Table 1. The volume of lung damage in patients with RA with COVID-19 who received biological DMARDs before infection CT-1 (&lt;25%) CT-2 (25-50%) CT-3 (50-75) CT-4 TNF-alpha inhibitors (n=4) 2 2 Abatacept (n=5) 1 2 2 Rituximab (n=37) 3 19 12 3 Tocilizumab (n=1) 1 Tofacitinib (n=5) 2 2 1 Total 8 (15,3%) 25 (48,1%) 16 (30,8%) 3 (5,8%) Conclusion Previous rituximab therapy in patients with rheumatoid arthritis is the most unfavorable prognostic factor during COVID-19 infection. Disclosure of Interests None declared
The impact of remote care on burden of treatment
Authors: Natalie Richards
Journal: BMJ (2022)

The impact of remote care on burden of treatment Natalie Richards research assistantBurden of treatment is the work that patients, and their carers and families, need to do to manage their healthcare, and how this affects their functioning and wellbeing. 1This burden can include managing long term conditions, monitoring health, and implementing lifestyle changes.Some of this work can be difficult, time consuming, and costly.
AB0365 BELIEFS AND ADHERENCE IN RHEUMATOID ARTHRITIS PATIENTS ON BIOLOGIC DRUGS
Authors: E. Hannech, S. Boussaid, S. Rekik, S. Jemmali, S. Rahmouni, H. Ajlani, H. Sahli, M. Elleuch, R. Dhahri, I. Gharsallah
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with chronic rheumatic diseases play an important role in their disease management. Adherence to their long-term therapies may depend on their therapeutic beliefs [1]. Objectives The purpose of our study was to investigate the relationship between beliefs and adherence among patients with rheumatoid arthritis (RA) on biologic therapies (bDMARDs). Methods We conducted a multi-centric cross-sectional study, including patients with RA fulfilling the ACR/EULAR 2010 criteria. All patients were on bDMARD. Sociodemographic, clinical, biologic, and therapeutic data were collected. Patients were interviewed about their medication beliefs using the Beliefs about Medicines Questionnaire (BMQ) and about their therapeutic adherence. Results There were 75 RA patients: 60 female (80%) and 15 males (20%). The sex ratio was about 0.25. Their mean age was 56.92±9.06 years [34-80]. Thirty-three percent of patients were illiterate. Twenty patients were employed (15%). The mean disease activity scale (DAS28 CRP) was 3.94±1.32 [1.21-7.15]. Fifteen patients (20%) had high disease activity, 11% had low activity, and 19% were in remission. The mean duration of the current bDMARD was 37.17±39.44 months [4-248]. The mean Specific Necessity score was 21.02±5.38 [5-25] for adherent patients and 13.5±7.54 [5-19] for non-adherent patients. The mean Specific Concerns score was 10.07±3.13 [5-15] for adherent patients and 15±2.82 [5-20] for non-adherent patients. A statistically significant association was found between Specific Concerns beliefs and adherence behavior (p=0.009) and between Specific Concerns beliefs and adherence behavior (p=0.003). No statistically significant association was noted between general beliefs (General Harm and General Overuse) and adherence behavior (p=0.4 and p=0.6 respectively). Conclusion Beliefs about therapeutic were identified as a key factor of adherence among rheumatic disease patients. Practitioners should detect negative patient beliefs and perceptions earlier to prevent nonadherence. References [1]Suh YS, Cheon YH, Kim HO, Kim RB, Park KS, Kim SH, Lee SG, Park EK, Hur J, Lee SI. Medication nonadherence in Korean patients with rheumatoid arthritis: the importance of belief about medication and illness perception. Korean J Intern Med. 2018 Jan;33(1):203-210. Disclosure of Interests None declared
AB0292 ASSOCIATION OF RHEUMATOID CACHEXIA WITH BONE, VERTEBRAL FRACTURES, AND STRUCTURAL JOINT DAMAGE IN MOROCCAN RHEUMATOID ARTHRITIS PATIENTS
Authors: M. Mahroug, H. Azzouzi, H. Boutaibi, F. Chennouf, I. Linda
Journal: Annals of the Rheumatic Diseases (2022)

Background The concurrent decrease in the fat-free mass index (FFMI) and increase in the fat mass index (FM) in rheumatoid arthritis (RA) is called rheumatoid cachexia (RC). There is limited data on RC association with osteoporosis, vertebral fracture (VF), and structural joint damage in RA. Objectives To explore rheumatoid cachexia association with bone, vertebral fractures, and radiographic damage in RA patients. Methods This was a cross-sectional study on RA patients fulfilling the ACR/EULAR 2010 criteria and recruited from December 2021 at our rheumatology department. Patients with prior cancer, chronic kidney disease, severe heart failure, severe chronic obstructive pulmonary disease, cirrhosis, hyperparathyroidism, thyroid dysfunction, diabetes, dysphagia, illicit drug use, alcohol abuse, and a body mass index (BMI) above 36kg/m 2 were excluded. RC was defined according to Engvall et al. (1) (as a fat-free mass index (FFMI) below the 10th percentile and a fat mass index (FMI) above the 25th percentile) and Elkan et al. (FFMI&lt;25 and FMI&gt;50) (2). Body composition, bone mineral density (BMD), and trabecular bone score (TBS) were obtained by dual-energy X-ray absorptiometry (DXA). Osteoporosis was defined as a T-score under 2.5. The radiographic joint damage was measured by the modified total Sharp /van der Heijde score (mTSS) using standard X-ray images of hands and feet. VFs were defined using the Genant semiquantitative approach as grade 2 or higher. Results We included 82 RA patients with a mean age of 51.90 ± 13.12 years. Their mean disease duration under treatment was 7.54 ± 5.69 years, and the mean mTSS was 93.84 ± 56.77. RC was observed in 11 (13.4 %) and 9 (11%) patients using both definitions, respectively. Osteoporosis was observed in 44 (53.7 %) patients. BMD was numerically lower in rheumatoid cachexia patients without significance while mean TBS was similar. The mTSS and particularly the mTSS erosion scores were significantly lower in RC patients (p &lt; 0.01). RA patients with RC (according to Elkan’s definition) had significantly more VF (p = 0.039). Conclusion RC was positively associated with VF, and RC patients were less erosive. References [1]Engvall I-L, Elkan A-C, Tengstrand B, Cederholm T, Brismar K, Hafstrom I. Cachexia in rheumatoid arthritis is associated with inflammatory activity, physical disability, and low bioavailable insulin-like growth factor. Scand J Rheumatol. oct 2008;37(5):321‑8. [2]Elkan A-C, Håkansson N, Frostegård J, Cederholm T, Hafström I. Rheumatoid cachexia is associated with dyslipidemia and low levels of atheroprotective natural antibodies against phosphorylcholine but not with dietary fat in patients with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther. 2009;11(2):R37. Disclosure of Interests None declared
AB1268 CLINICAL ASPECT AND THERAPEUTIC MANAGEMENT OF SUBACUTE OSTEOMYELITIS IN CHILDREN
Authors: R. Dghaies, A. Dghaies, M. Jerbi, H. Ben Ghozlene, F. Abid
Journal: Annals of the Rheumatic Diseases (2022)

Background Subacute osteomyelitis in children is a distinct entity encompassing primary localized osteomyelitis. It poses a diagnostic problem related to its few or no constitutional symptoms, misleading radiological manifestations and often a negative bacteriological investigations. The treatment remains very controversial. Objectives The aim of this study was to identify the main epidemiological, clinical, histological and evolutionary characteristics of this affection and to propose an adequate therapeutic attitude. Methods It was a retrospective longitudinal study, carried out over a period of 25 years from January 1995 to December 2019 in the orthopedic department of Taher Sfar Hospital,Mahdia, that included 37 cases of subacute osteomyelitis in children. Results The mean age of the patients was seven years nine months with a male predominance (sex ratio: 2.27). The average time to hospitalization was 41 days. A diagnostic delay was very likely because of delay in consultation which was related to clinical latency, reported in all cases. The imaging showed osteolysis in all cases, setting in long bones in 54% of cases and in 46% other cases in short and flat ones. The lesion was multiple in two different bones only in one case and was found in pure epiphyseal location in seven cases. The bacteriological investigation allowed the isolation of a germ only in eight cases. In all cases, it was a Staphylococcus aureus. Surgical treatment was performed in 21 cases (60% of patients). The outcome was favorable in 35 cases (95% of cases). An infectious awakening was noted in 2 cases. Conclusion Subacute osteomyelitis poses a diagnosis and therapeutic problem. Magnetic resonance imaging is a valuable examination. Surgical treatment combined with appropriate antibiotic therapy is indicated for any suspicious lesion. It can be useful in taking samples for diagnosis, improve distribution of the antibiotic in injury and accelerate healing radiation. Disclosure of Interests None declared
AB0048 THE SUPPRESSION OF INFLAMMATORY PROCESSES AND MODULATION OF MAPK SIGNALING BY SHIKONIN DERIVATIVES IN PRIMARY OA CHONDROCYTES
Authors: B. Lohberger, H. Kaltenegger, N. Eck, D. Glänzer, A. Leithner, R. Bauer, N. Kretschmer, B. Steinecker-Frohnwieser
Journal: Annals of the Rheumatic Diseases (2022)

Background Osteoarthritis (OA) is one of the most common joint disorders and is characterized by the degeneration and loss of articular cartilage with chronic arthritis of the joint edge and subchondral bone. OA is causally influenced by several factors, including age, gender, familial susceptibility, as well as local biomechanics, cartilage cell apoptosis, and the action of degenerative enzymes. Despite intensive research, there are still few effective therapeutic approaches. Objectives In the rat OA model, shikonin was shown to inhibit inflammatory processes and chondrocyte apoptosis by regulating the PI3K/AKT pathway. Therefore, we investigated the effect of shikonin and its derivatives acetylshikonin and cyclopropylshikonin on inflammation, MMP expression, and regulation of MAPK signaling in human OA chondrocytes. Methods Viability was analyzed using the CellTiter 96 AQ ueous Luminescence Assay on human healthy chondrocytes (HC) and primary OA chondrocytes (pCH-OA). For the study of inflammatory processes, we performed a proteome profile screening assay. As MAPK signaling pathways play a key role in cartilage destruction in OA, we analyzed the effects of shikonin and its derivatives using protein expression analysis of the phosphorylation pattern and the corresponding downstream gene regulation using RT-qPCR. Results Both HC and pCH-OA showed a dose-dependent inhibition of cell viability after treatment with shikonin derivatives, whereby the strongest effects were found for shikonin with IC 50 values of 1.2 µM and 1.3 µM, respectively. Shikonin counteracts inflammatory response caused by IL-1β by massively reducing the expression of pro-inflammatory mediators. Phosphorylation level of ERK changed slightly, pJNK and pp38 showed a significant increase after treatment with the shikonin derivatives both in HC and pCH-OA cells. The downstream targets c/EBPs and MEF2c may play a role in the homeostasis of joint cartilage under physiological and pathological conditions. The phosphorylation level of STAT3 significantly decreased in a dose-dependent manner after treatment. STAT3 blockade has a chondroprotective function through a regulation of cyclin D1 or Sox9. Conclusion Our results demonstrate for the first time that shikonin and its derivatives acetylshikonin and cyclopropylshikonin have extensive effects on inflammatory processes, MAPKs, and IL6/STAT3 downstream regulation in human healthy chondrocytes and primary OA chondrocytes. References none Disclosure of Interests None declared
Advances in the management of idiopathic pulmonary fibrosis and progressive pulmonary fibrosis
Authors: Gabrielle Y Liu, G R Scott Budinger, Jane E Dematte
Journal: BMJ (2022)

ABSTRACT Similarly to idiopathic pulmonary fibrosis (IPF), other interstitial lung diseases can develop progressive pulmonary fibrosis (PPF) characterized by declining lung function, a poor response to immunomodulatory therapies, and early mortality. The pathophysiology of disordered lung repair involves common downstream pathways that lead to pulmonary fibrosis in both IPF and PPF. The antifibrotic drugs, such as nintedanib, are indicated for the treatment of IPF and PPF, and new therapies are being evaluated in clinical trials. Clinical, radiographic, and molecular biomarkers are needed to identify patients with PPF and subgroups of patients likely to respond to specific therapies. This article reviews the evidence supporting the use of specific therapies in patients with IPF and PPF, discusses agents being considered in clinical trials, and considers potential biomarkers based on disease pathogenesis that might be used to provide a personalized approach to care.
AB0518 OBESITY PARADOX IN SLE PATIENTS LOWER BMI TRADUCES TO HIGHER DISEASE ACTIVITY.
Authors: M. A. Balderas-Palacios, D. Á. Galarza-Delgado, I. J. Colunga-Pedraza, J. R. Azpiri-López, A. N. Garza-Cisneros, A. Garcia-Heredia, A. B. Rodriguez-Romero, N. Guajardo-Jauregui, A. Cárdenas
Journal: Annals of the Rheumatic Diseases (2022)

Background Cachexia plays an important role in rheumatoid arthritis (RA), due to its chronic inflammatory process characterized by decreased muscular mass with preservation or increase of fat that occurs in 1-13% of the RA population. A decreased BMI has a paradoxical relationship with disease activity, with an increase in disease activity and mortality (1). Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of nuclear autoantibodies that can form immune complexes and cause inflammation of multiple organs. Cardiovascular events and mortality are nearly twice as high in patients with SLE as in the general population. (2) Objectives To determine the relationship between BMI and disease activity in patients with SLE. Methods A cross-sectional, observational study was conducted in which a group of 58 patients with SLE were included and their level of disease activity was determined using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and BMI. Distribution was assessed with the Kolmogorov-Smirnov test. Descriptive analysis using measures of central tendency. Correlation between BMI and SLEDAI with Pearson’s test. A p value &lt;0.05 was considered statistically significant. Results The mean age of SLE patients was 35.4 ± 12.11 years, rest of demographic characteristics in Table 1. Pearson’s test showed a correlation between BMI and disease activity (r= Table 1. Demographic characteristics SLE n=58 Female n (%) 54 (93.0) Age, years, mean ± SD 35.4 ± 12.1 DM n (%) 2 (3.4) AH n (%) 12 (20.6) DLP n (%) 4 (6.8) Obesity n (%) 4 (6.8) SLEDAI mean ± SD 8.06 ± 6.4 ANA positivity n (%) 47 (81.0) BMI mean ± SD 25.0 ± 4.9 DM; Diabetes Mellitus, AH; Arterial Hypertension, DLP; Dyslipidemia, SLEDAI; Systemic Lupus Erythematosus Disease Activity Index, ANA; Anti-Nuclear Antibodies, BMI; Body Mass Index. -0.304, p= 0.020) Image 1. Multivariate analysis found that a decrease in BMI is independently associated with an increase in disease activity assessed by SLEDAI (B= -0.411, 95% CI= -0.819- -0.003, p=0.049). Figure 1. Correlation between BMI and SLEDAI. Conclusion The results show an inverse relationship between BMI and disease activity in patients with SLE. Further studies with a larger number of patients should be performed. References [1]Summers GD, Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD. Rheumatoid cachexia and cardiovascular disease. Nat Rev Rheumatol [Internet]. 2010;6(8):445–51. Available from: http://dx.doi.org/10.1038/nrrheum.2010.105 [2]Ocampo-Piraquive V, Nieto-Aristizábal I, Cañas CA, Tobón GJ. Mortality in systemic lupus erythematosus: causes, predictors and interventions. Expert Rev Clin Immunol [Internet]. 2018;14(12):1043–53. Available from: https://doi.org/10.1080/1744666X.2018.1538789 Disclosure of Interests None declared
POS0949 NO CHANGE IN SERUM LEVELS OF BONE TURNOVER MARKERS CORRECTED FOR AGE AND GENDER DURING THE FIRST YEAR OF SECUKINUMAB TREATMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS
Authors: M. Siderius, S. Arends, F. Wink, A. Spoorenberg
Journal: Annals of the Rheumatic Diseases (2022)

Background In patients with ankylosing spondylitis (AS), TNF-α inhibitors influence the course of serum bone turnover markers (BTM), favoring an increase in mineralization during the first years 1 . Little is known about the effect of IL-17 inhibitors on these serum BTM levels. Objectives To evaluate serum markers of bone resorption, formation, and mineralization during 1 year of secukinumab treatment in AS patients in daily clinical practice. Methods Included were consecutive outpatients from the GLAS cohort with a clinical diagnosis of AS who started treatment with secukinumab between April 2016 and June 2020, and had available serum samples at ≥1 visit. Standardized follow-up visits were performed at baseline (before start of secukinumab) and after 3 or 6 months and 1 year of treatment. BTM were measured in serum: osteocalcin (OC; regulation marker), serum type 1 collagen C-telopeptide (sCTX; collagen resorption marker), procollagen type 1 N-terminal peptide (PINP; collagen formation marker) and bone-specific alkaline phosphatase (BALP; bone mineralization marker). BTM Z-scores were calculated using a healthy reference population to correct for the normal influence of age and gender. Patients using bisphosphonates were excluded from analyses. Data was coded missing if patients experienced a fracture or received systemic corticosteroids within 1 year of a study visit. Generalized estimating equations were used to analyze BTM Z-scores over time within patients. Results In total, data of 26 AS patients were eligible for analyses; 50% were male, mean age was 46.0±14.6 years, 81% were HLA-B27 positive, mean ASDAS at baseline was 3.7±1.0, and 50% was TNFi naïve. Before secukinumab treatment, median PINP and BALP Z-scores were +0.6 and +0.7 SD, respectively, compared to age and gender matched healthy controls, however, the large majority remained within the normal range of ±2 SD. Overall, BTM Z-scores of OC, sCTX, PINP and BALP did not change significantly compared to baseline during the 1st year of secukinumab treatment (Figure 1). Conclusion In daily clinical practice, serum BTM levels including mineralization corrected for the normal influence of age and gender did not change during the 1 st year of secukinumab treatment in patients with AS. Our data confirm recent findings of stable BTM levels at group level during 2 years of secukinumab treatment in posthoc analysis of MEASURE 1 2 . References [1]Arends et al. Arthritis Res Ther. 2012;14(2):R98 [2]Braun et al. BMC Musculoskelet Disord 22, 1037 (2021 Acknowledgements This study was supported by an investigator initiated research grant from Novartis. Disclosure of Interests Mark Siderius: None declared, Suzanne Arends: None declared, Freke Wink: None declared, Anneke Spoorenberg Consultant of: AbbVie, Novartis Pharma, Pfizer, UCB Pharma, Lilly, Grant/research support from: Novartis Pharma, Pfizer